Tag: organ donation

Organ donation awareness

Left to right are panelists at a recent National Council of Jewish Women panel on organ transplants: Dr. Aviva Goldberg, Rabbi Yossi Benarroch, Marshall Miller and Na’ama Miller. (photo from NCJW)

On Dec. 11, the Winnipeg section of National Council of Jewish Women (NCJW) held an organ donation awareness event, featuring community members Rabbi Yossi Benarroch, Dr. Aviva Goldberg, and husband (organ recipient) and wife (organ donor) Marshall and Na’ama Miller.

Benarroch spoke first, after a welcome from organizers and a video about organ donation (youtube.com/watch?v=5cfaAWTH5zM).

“The short of it is, basically, that Jewish law permits organ donations,” he said. “There’s no question about that. Of course, when we talk about law, law is complicated and there are lots of opinions. There’s an ideal in Judaism, which is one of those foundations, and it’s called ‘pikuach nefesh doche hakol’ … which basically means that, in Judaism, there’s nothing more important than saving a life.

“I’m a very observant Jew and I keep kosher,” he said, “but if I had to eat something that wasn’t kosher – pork or whatever – in order to save my life, then Jewish law says you’re obligated to do that.”

Benarroch said it is written that, if someone saves a life, it is as if they have saved the entire world. Furthermore, he said, we are called to not stand idly by if another person is suffering. “We are obligated to intervene and actually obligated to help that individual,” he said.

Marshall Miller, who was diagnosed with progressive kidney disease more than 25 years ago, eventually required replacement therapy.

“Slowly, over time, my kidney failure began to get worse and worse,” he shared. “The disease progressed to the point where, a few years back, my GP at the time said, ‘Marshall, you’re now at the point where you have to go see a specialist because I can’t do anything more for you here … you need an expert to deal with your situation.’

“Everybody who suffers from kidney disease understands that, what kidneys do, among many things, is purify your blood. When your blood isn’t being purified properly, you can start to feel kind of lousy. I think my family can attest to the fact that I was starting to feel lousy. I think my whole family suffered along as I did, as I got sicker and sicker.”

When his kidney function was down to less than 10%, the specialist started talking seriously about replacement therapy. This involved dialysis three times a week until a matching donor could be found.

During the search for a donor, Na’ama Miller decided to find out if she might be able to help other people in her husband’s situation. As it turned out, she was a match for her husband.

“We were told it was a one hundred million shot,” she said. “And so, we were next faced with a bit of a dilemma … because it was scary for the kids. But Samantha and Maya were very much in favour of it, because they didn’t want me to be miserable anymore.”

She said, “People ask me, how I could do this … if it was hard. I give everyone the same answer. It was a no-brainer, a very easy decision for me. As Marshall said … we were all suffering along with him.”

“It’s worth it. You saved a life,” her husband added. “We hope this event here – even if only one more person signs up … hopefully, more and more people will choose to do it among the Jewish community after hearing the story.”

After the Millers spoke, a second video was screened, about a former Winnipegger who donated a kidney to save the life of a woman in California, who he has never met.

“Right now, in Canada, there are over 4,500 people waiting for an organ transplant – 4,500 Marshalls,” said Goldberg, who is the director of the Canadian Society of Transplantation and chair of the Transplant Manitoba kidney allocation review committee. “We don’t have 4,500 Na’amas. That’s why we need donors – both living and also deceased donors.

“That’s what we want to talk about today,” she said, “even if you don’t go forward to become a living donor, which is a really big deal. It’s not something that every person in this room is going to be able to do and that’s totally fair. But, there’s something that everyone in this room can do and that’s to sign up for organ donation after you’ve died – say that this is something I’d like to do, that you’d like to leave a legacy … you can save lives after you’ve died, either with organ or tissue donation. You can save lives by donating organs – heart, liver, lungs, pancreas, kidneys and even small bowel – but, also tissue donation.”

In some cases, people can donate their corneas to help improve the life of others. According to Goldberg, Manitoba, last year, was the fourth on the world list of most donors.

While Goldberg implored people to sign up as donors online, she further reminded them that talking to family about your willingness to be a donor is also very important – and not just immediate family, as they might be in the same car with you when you have a horrific accident, for example.

“The way that organ donation works in Canada, here, in Manitoba, is that after someone has died and they are potentially going to be an organ donor, their family is approached,” said Goldberg. “If you sign up for the registry, it’s a way of saying to your family, on the very worst day of their lives, that this is something your loved one wanted – wanted so much that they went to the registry, signed up, made that choice. It’s a hard discussion to have … [but] it’s so important to do.”

During the question-and-answer period, one attendee asked if there was an age limit for someone to donate an organ. The answer? “No.”

Another question was about the possibility of rejection and, to that, Marshall Miller shared his experience. “I suffered from a mild early rejection,” he said. “But, the ability to detect the rejection and be able to remedy it is incredible. They were able to treat me with medication instantaneously and, really, it was a non-issue for me. Even though there is a risk of rejection, it can easily be found if you attend your appointments and take your medication.”

For information on organ donation in British Columbia and to register, visit transplant.bc.ca.

Rebeca Kuropatwa is a Winnipeg freelance writer.

Increasing organ donations

Leading up to the provincial election in Manitoba in April, activists, family members of organ recipients and those waiting for organs pushed the topic of organ donation as an election issue. They reached out to many prominent people to help them spread their message, including Prof. Arthur Schafer, founding director of the Centre for Professional and Applied Ethics at the University of Manitoba.

The centre’s purpose is to promote research specifically in applied ethics across different professions, such as medicine, engineering, pharmacy and nursing. Schafer further described it as “ethics as it applies to controversial, moral, social and political issues in society.”

Organ donation, while supported by most segments of the population, has been an issue with which many countries struggle. As there is most often a gap between supply and demand, some countries are coming up with new ways to tackle the problem.

photo - Prof. Arthur Schafer
University of Manitoba’s Prof. Arthur Schafer. (photo from Arthur Schafer)

“Israel used to have just about the lowest organ donation rate of all the Western countries,” said Schafer. “So, historically, and rather embarrassingly, more people died waiting for an organ donation in Israel than anywhere else.”

According to Schafer, the lack stemmed from the common misconception that Jewish law prohibits organ donation.

“But, the very low donation rate in Israel changed after a new law was passed in 2008,” he said. “The new law gave priority [to certain people]. It was still true, after the new law was passed, that medical need was the most important criteria. Someone faced with imminent death would have priority over someone whose need was less urgent but, when patients had comparable need, the 2008 law gave priority to those who’d signed an organ donor card or whose family had donated an organ.”

The policy was nicknamed, “Don’t Give. Don’t Get.” Schafer said what this meant was that, if someone, for religious or other reasons, would not sign an organ donor card, they might end up dying themselves as a result of having a lower priority on the list of waiting patients.

“I suppose it’s the dual moral justification … first of all, a principle of justice or fairness,” said Schafer. “If you aren’t willing to give, you don’t deserve, you could argue, it’s not fair for you to take when you’re not willing to donate.

“Then, there’s also the principle of maximizing benefit, because this law seems to have resulted in saving many lives – which, according to Jewish law, is supposed to be of the highest priority. Jewish law says that saving a life is more important than anything else. Yet, many Orthodox Jews refuse to sign an organ donor card.”

Schafer said that, while the supply gap in Israel is still significant, it has narrowed dramatically since the passage of this new law.

Meanwhile, in Canada and its provinces, there is no priority given at present to those who sign an organ donor card.

As for the current local situation, the Province of Manitoba has passed a law – called Required Consideration – that requires physicians to consider whether someone dying or near death is a suitable candidate for organ donation, and to ask them or the family about donating.

Other provinces, like Ontario and British Columbia, have taken it a step further, passing a law known as Required Request. Doctors must discuss organ donation with dying patients. In both of these provinces, doctors can take themselves out of the process by alerting an organ donation coordinator to the situation.

“Many physicians are quite squeamish about the topic, by the way, especially when a younger person has died tragically in a car accident,” said Schafer. “Their organs might be a potential source of numerous healthy organs that could save lives but doctors feel, due to the severe family grief resulting from the death of a young person, that they don’t want to add to the burden by asking for an organ donation. That’s a fairly understandable reaction. But, I think it’s profoundly wrong. I think that, if your child has died in an accident or suffered from an untimely death, the family might welcome the opportunity to make something morally significant by agreeing to have other lives saved through organ donation. I think many people actually feel this way and that doctors who are reluctant to ask the families about it are depriving them of an opportunity.”

Schafer went on to say that, in many provinces, there is a big push to change the system of organ donation so that it would be a choice of opting out as opposed to one of opting in. The current situation is that, if you do not tick the box or tell your family you want to donate, your organs will not be harvested. Schafer contends that reversing the onus is a good option, as it still gives individuals a choice, but they have to choose not to do it rather than to do it.

“Many European countries have adopted opting-out systems, such as Spain,” he said. “Their donation rates have gone up considerably.”

Another option Schafer suggested is to tweak the compensation system for doctors, giving them further incentive to talk to people about organ donation when there is not the option of referring the matter to an organ coordinator.

“Many people die in community hospitals, nursing homes or in their own homes,” he said. “The family doctor, rural doctor or community hospital doctors are often unwilling to take the time filling out the forms to arrange for organ donation. I think the medical profession itself has been a big impediment to an increase in cadaveric organ donation.

“If you’re in a teaching hospital where transplant operations are occurring, you’re more likely to approach the family or individual and arrange organ donation,” he continued. “If you’re in a community hospital, it takes time. You have to fill out forms, you have to speak to people, and you’re not reimbursed. I think part of the solution to the dramatic gap between the supply and demand for organs requires a change in the medical profession itself or making it a requirement for doctors.”

The possible downside to a change in the compensation system for doctors, however, is to ensure that they still do all they can to save a patient.

For information on becoming an organ donor in British Columbia, visit transplant.bc.ca/be-donor.

Rebeca Kuropatwa is a Winnipeg freelance writer.